A keyhole approach gives a sound repair for ileal conduit parastomal hernia

Hernia. 2022 Apr;26(2):647-651. doi: 10.1007/s10029-021-02550-1. Epub 2022 Feb 11.

Abstract

Purpose: The purpose of this study was to report and evaluate a laparoscopic surgical technique for the treatment of parastomal hernia (PSH) after ileal conduit urinary diversion aiming to minimize PSH recurrence and perioperative complications.

Methods: We retrospectively evaluated all patients who underwent a PSH (after ileal conduit urinary diversion) repair at Addenbrookes Hospital, Cambridge. As a surgical approach, a laparoscopic repair with mesh was utilized in all cases. Subsequently, we performed a voluntary follow-up of the patients to evaluate long-term recurrence and complication rates. In addition, we conducted a reassessment of the cross-sectional imaging available.

Results: Between November 2008 and December 2019, 27 patients underwent hernia repair due to a clinically significant hernia. Out of those patients, one suffered from a post-operative wound infection. In total 23 patients participated in the follow-up with a median follow-up period of 91 months. Follow-up examination revealed two cases of recurrent PSH (8.7% of patients followed up), four patients suffered from minor complications (14.8%).

Conclusion: Repair of PSH associated with ileal conduit is particularly scarce. Our surgical approach presents the only laparoscopic case series of an effective method for treating a PSH from an ileal conduit with a low complication and recurrence rate.

Keywords: Ileal conduit; Kayhole repair; Laparoscopic surgery; Mesh; Parastomal hernia; Surgery.

MeSH terms

  • Hernia, Ventral* / etiology
  • Hernia, Ventral* / surgery
  • Herniorrhaphy / adverse effects
  • Humans
  • Incisional Hernia* / complications
  • Incisional Hernia* / surgery
  • Retrospective Studies
  • Surgical Mesh / adverse effects
  • Surgical Stomas* / adverse effects
  • Urinary Diversion* / adverse effects